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What does this week's Covid-19 data tell us about Ireland's third wave?

Ireland’s reproductive number is estimated at between 0.4 and 0.7 having stood at between 0.5 and 0.8 last week.

Screenshot 2021-01-28 at 15.22.32 - Display 2 Source: Department of Health

FIVE WEEKS INTO Level 5 – and five more to go – Ireland’s suppression of Covid-19 is working. 

A total of 3,635 new cases were confirmed across Monday, Tuesday and Wednesday – compared to more than 6,500 new cases reported over the same period last week and 11,000 cases in the preceding week. 

Hospitalisations, ICU admissions and mortality remain extremely high. 

Ireland’s national incidence rate is 621.9 cases per 100,000 of the population on a 14-day rolling average, according to data from the Health Protection Surveillance Centre – compared to 1,140.7 on this day last week and 1,497.0 the week previous.

Ireland’s reproductive number (Re) is estimated at between 0.4 and 0.7 having stood at between 0.5 and 0.8 last week. 

There is the basic reproduction number (R0), which is the number of people who will be infected if no other factors are taken into account.

Then there is the effective reproductive number (Re) - the number of people who will be infected if you take into account other factors, such as immunity through previous infection or vaccination or behaviour which has been altered by social distancing measures.

It is estimated that SARS-CoV-2 has an R0 of between 2 and 3.

To recap, NPHET’s modelling last week projected between 1,400 – 1,700 cases per day by 31 January if the R Number was maintained at between 0.5 and 0.8. 

Chair of NPHET’s Irish Epidemiological Modelling Advisory Group Professor Philip Nolan said it would be hard to maintain that rate of suppression due to increased prevalence of the more transmissible UK variant. 

However, Ireland is now below that model – an R Number of between 0.4 and 0.7 and a 5-day average of 1,250 cases. 

“I’m more confident that we’ll get to where we need to be at the end of February,” Nolan told TheJournal.ie, adding that cases could be between 200 – 400 by then if restrictions are maintained. 

“What’s happened is we’ve suppressed transmission so much that we’ve slowed the UK variant’s path to dominance,” said Nolan. “It will [become dominant] but just more slowly.”

The average number of close contacts per case has also dropped further – from 2.3 on 14 January to 2.1 today. 

Nolan said that the next few days will be crucial in determining if our rate of decline slows. “If we keep this up for another couple of weeks we will have case numbers down very low.”

Incidence Rates 

Looking at 14-day incidence rates in individual counties, Monaghan has the highest incidence of Covid-19 in Ireland at 1,373.3 cases per 100,000 – a 50% reduction in incidence since Thursday 14 January. 

Louth is the second-highest county in Ireland with a 14-day incidence rate of 906.8. Carlow is third-highest with a 14-day incidence rate of 874.4. 

Looking at Local Electoral Area data, Belmullet in Mayo remains the area with the highest individual incidence of Covid-19 at 2,007.9 cases per 100,000.

Enniscorthy in Co Wexford has the second-highest incidence of Covid-19 at 1,614.5 cases per 100,000. 

Ballybay-Clones in Co Monaghan is third-highest incidence of Covid-19 at 1,501 cases per 100,000. 

For a breakdown of Covid-19 incidence rates in LEAs around Ireland, see here

Counties with the current lowest incidence rates include Leitrim (271.5), Roscommon (336.2) and Kerry (347.3). 

Outbreaks

Despite these positive trends, there remains an “exceptionally high incidence” of Covid-19 among people over 85 and a “very concerning” level of disease in those aged over 65, Chief Medical Officer said in a letter to Health Minister Stephen Donnelly last week. 

Fourteen outbreaks in nursing homes were notified in one day early last week – a stark reminder of the impact Ireland’s Third Wave continues to have in these settings. 

“The risk in [long-term residential care facilities] cannot be fully mitigated,” Holohan said.

“We are seeing increasing mortality and expect a large number of additional deaths in the coming weeks.”

The Department of Public Health Mid-West said on Tuesday that, despite a “sizeable buy-in” from people in reducing transmission, complacency remains a concern. 

“Previous experience has shown that where is there is a noticeable drop in cases, there can be a shift in behaviours whereby some members of the public relax their efforts, which then leads to more cases and outbreaks in the community,” said Dr Mai Mannix, Director of Public Health Mid-West.

Hospital & ICU

There have been 77 hospital admissions in the last 24 hours and 132 discharges. 

There are – as of this morning – 1,620 confirmed Covid-19 cases in hospital and 216 people in Intensive Care Units.

There were 1,969 confirmed Covid-19 cases in hospital and 214 people in Intensive Care Units last Friday. 

Screenshot 2021-01-28 at 14.42.28 - Display 2 Source: Department of Health

In a letter to Health Minister Stephen Donnelly last Thursday, Chief Medical Dr Tony Holohan said Ireland’s health system continues to be under “immense pressure”. 

He said the average time spent in hospital or ICU units remains considerable but comparable to previous waves of infection. 

“There is no evidence of a change in individual risk of morbidity or mortality associated with [Covid-19] since the onset of the pandemic,” said Dr Holohan. 

“[It] remains as virulent with the same potential for severe adverse health outcomes.”

In terms of hospital capacity, HSE CEO Paul Reid said today that ICU capacity is “close to a tipping point” with only 18 ICU beds left available across the country. 

Testing & Tracing 

Testing in January had been curtailed by demand. Close contacts of confirmed cases stopped being tested as the HSE prioritises people with symptoms.

However, the HSE confirmed that from today, testing of asymptomatic close contacts will resume. 

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Testing had ramped up to almost 25,000 per day in early January. It slightly reduced to an average of 23,000 per day by 14 January and has reduced further to an average of 22,000 tests per day for the past two weeks. 

On 7 January, approximately 174,000 tests had been carried out in the previous seven days. The positivity rate was 22.7%. 

Approximately 167,000 tests were carried out between then and 14 January. The positivity rate reduced further to 17.9%.

Last week, approximately 154,000 tests have been carried out in the past seven days. The positivity rate is currently 11.8%. 

There has been a further reduction in the positivity rate again this week. 

Approximately 142,000 tests have been carried out in the past seven days as of Thursday. The positivity rate is currently 8.1%. 

Vaccinations 

Finally, 161,500 vaccinations have been administered in Ireland. That is 39,600 doses administered since last week

Of the 161,500 vaccines administered so far, 71,600 have been in long-term residential care settings – all of which have been first doses – with 89,900 administered to frontline healthcare workers. 

Of those, 76,100 have been given a first dose with 13,800 frontline healthcare workers now fully vaccinated. 

The HSE said yesterday that a further 6,551 vaccines will be administered in 78 long-term residential care settings by Sunday. 

A total of 46,000 second doses are due to be administered to frontline healthcare workers and at long-term residential care facilities next week. 

Healthcare workers with direct patient contact as well as residents at long-term residential care facilities over the age of 65 have been first to receive the vaccine. 

Both vaccines currently being used in the roll out – the Pfizer vaccine and the Moderna vaccine – are mRNA vaccines that require a two-dose schedule.

Screenshot 2021-01-28 at 14.40.27 - Display 2

The Government had expected AstraZeneca’s vaccine to be approved by the EMA on 29 January, paving the way for 100,000 vaccinations per week in Ireland. 

However, AstraZeneca’s vaccine this week made headlines after reports regarding its efficacy in over 65s amid a row between the company and the EU. 

Germany’s Vaccine Commission recommended the use of AstraZeneca’s vaccine only for under-65-year-olds, due to insufficient data on its effectiveness on older people.

AstraZeneca said it could only supply a quarter of the doses it had promised for the first quarter of 2021.

Health Minister Stephen Donnelly said that – despite this setback – Ireland is in line to receive 11 million doses of other vaccines this year. 

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